NPI 1639521206
Kyle Allen Clark, DMD
Practice location
- Address
- 113 Cross Creek Blvd, Salem, IL 62881-1921
- Phone
- (618) 548-4480
Registered specialties
General Practice Dentistry
Primary
Registry record
- NPI
- 1639521206
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 7 Jul 2016
- Record last updated
- 7 Jul 2016
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.